A RING-shaped nerve zapper could be a radical new treatment for overactive bladder in women.
The 5cm-wide gadget, which is the shape of a ring doughnut, has eight electrodes around the outside that each generate a mild electric current.
It is inserted via the vagina and, as the current passes into the surrounding tissue, it stimulates nerves connected to muscles responsible for controlling bladder function. This stops the muscles from contracting too much – as they do in an overactive bladder – curbing the desire to go to the loo.
Overactive bladder affects around five million women in the UK and causes a sudden need to urinate. It stems from a problem with the detrusor muscles, located in the bladder wall. Normally, they relax to allow the bladder to fill, and contract when it is full.
In overactive bladder, the muscles contract too often, creating an urgent need to urinate even when the bladder is not full.
The condition is more common among the elderly and can also be triggered by alcohol or caffeine – both of which can irritate muscles in the bladder wall – as well as drinking too little, which can have a similar effect.
Medications – such as blood pressure pills called ACE inhibitors and some antidepressants – can also be a factor.
Treatment usually starts with bladder training exercises to improve control. Drugs can help tone the bladder muscles, but may have side-effects such as dry mouth, dry eyes and constipation.
The ring, called FemPulse, could provide a convenient, drug-free way to combat the problem. The device wedges around the opening to the cervix.
The idea is that GPs will instruct women on how to fit the ring, but they can then do it themselves at home (each has a battery that lasts 30 days, after which a replacement will be needed, although the cost is not yet known).
The ring is switched on using an app on the patient’s smartphone. The electrodes are positioned to target bundles of nerves – called autonomic plexuses – that control muscles in the bladder wall.
This form of treatment, known as neuromodulation, is already used by the NHS in severe cases of overactive bladder.
But, currently, it involves surgery to implant a wire in the lower back. The wire is connected to a generator beneath the skin in the buttock.
For women, the FemPulse ring could be a much more convenient solution. The app allows them to adjust the power to each of the electrodes, to see which provides the best results.
A study involving dozens of women is under way in the U.S. and the results are due to be published later this year.
If trials are successful, the ring could be in use in the UK within two to three years.
Marc Laniado, a consultant urologist at Frimley Health NHS Trust in Surrey, said: ‘This is potentially very useful, but it must be proven to be effective in trials before it can be widely used.’
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